anonymous on August 30, 2011

I have diabetes...what is retrograde ejaculation and is it curable? Does it mean I’m sterile?

I am a 32-year-old male, and I have diabetes and use insulin. Over the past five years, I’ve noticed that the amount of semen I produce has drastically decreased. I have read in a medical encyclopedia that men with diabetes often suffer from "retrograde ejaculation." Is this the cause? Does it mean I'm sterile?

answered by Lisa Oldson, MD on August 30, 2011

Thanks for sharing your important questions with us. First, I would encourage you to speak with your regular doctor for an examination and to determine whether you have retrograde ejaculation or another issue...meanwhile, here are some thoughts for your consideration.

Retrograde ejaculation is a condition that occurs when semen enters the bladder, instead of exiting the body out of the penis upon ejaculation. A man who has retrograde ejaculation might notice that he doesn’t ejaculate much, if at all, even though he is still able to experience orgasm.

What causes retrograde ejaculation? If you take a look at the male reproductive system, you’ll notice several different organs and tubes that make and distribute the various fluids of the reproductive system. For example, sperm is created in the testicles and matures in a coiled tube at the back of the testicles called the epididymis.

When a man ejaculates, the epididymis forces mature sperm into a tube called the vas deferens. The vas deferens is a long tube that takes the sperm to the prostate gland where the sperm mix with prostate fluid to create semen. Typically, when a healthy man ejaculates, the semen will enter the urethra and exit the body (ejaculation).

The urethra doesn’t just take semen out of the body, also carries urine from the bladder out of the body.

Typically, a valve regulates what fluid (semen or urine) enters the urethra. When the penis is not erect, the valve allows urine into the urethra. And when the penis is erect, the valve blocks urine from entering the urethra and allows semen to flow through the urethra.

In men who experience retrograde ejaculation, the valve between the bladder and the urethra doesn’t work correctly. The valve doesn’t close the passage between the bladder and the urethra, and therefore allows semen to rush into the bladder during ejaculation. Luckily, semen in the bladder doesn’t cause any serious health problems but it’s still a good idea to talk with your doctor about it.

Retrograde ejaculation could signify a problem with blood sugar regulation in men with diabetes. Again, I hope you’ll speak with your doctor about your symptom of decreased semen amounts when you ejaculate because it may be a sign of poorly regulated blood sugar.

As well, your doctor can help you determine the best nutrition and insulin schedules for you, which might also help. Also, some men who experience retrograde ejaculation benefit from certain prescription medications.

Finally, does retrograde ejaculation effect your fertility? In short, yes. Because retrograde ejaculation forces semen into the bladder, conception through sexual intercourse is more difficult.

If you and a partner are trying to have a baby, you can also talk to your doctor or a fertility specialist who may be able to help you with options to assist in conception. The good news is that retrograde ejaculation only affects where the semen doesn’t change your ability to produce sperm.

I hope this information is useful to you, and I wish you the best of health.

Related info:  

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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